DIFFUSE INTERSTITIAL PNEUMONIA LINKED TO 5-AMINOSALYCILATE

Iatrogenic pneumonias to sulphasalazine are most usually seen during t he course of a haemorrhagic procto colitis (RCH). We report a case in which a young woman was treated with 5-aminosalycilate (Pentasa(R)) an d prednisolone during an exacerbation of RCH. After 3 months of treatm ent the steroid therapy was stopped and the Pentasa(R) was continued a t the same dose (3 g per day). She presented with increasing dyspnoea on effort. Clinical examination was normal but a CT scan of the chest showed interstitial micro nodules; there was also a restrictive ventil atory disorder, hypoxaemia on effort and an alveolar eosinophilia (1.8 %) The clinical progress, respiratory and blood gases all improved rap idly after stopping the Pentasa(R) with the disappearance of the inter stitial nodule over 5 months, suggesting that the role of the Pentasa( R) was causal in the genesis of the pneumonia.